Image of a young woman in the kitchen holding a pepper

Fast, long-lasting relief from reflux

When traveling, graphic design consultant Sandy Balthaser was frequently on deadline, so downtime wasn’t an option. Then she was burdened with a hiatal hernia, and with it the stomach-churning gastrointestinal esophageal reflux disease (GERD). “It worsened gradually,” says Sandy, 53. “I was in the middle of an intense work project and realized my focus was too often on my stomach pain and indigestion. The discomfort was interfering with the sleep I needed to be at my best.”


Sandy scheduled a check-up with her primary care doctor, Ena Kariya, M.D., to share her concerns. When additional tests were needed, Dr. Kariya sent Sandy to Orange Coast Medical Center gastroenterologist Ashkan Farhadi, M.D.

Dr. Farhadi and the specialists at the MemorialCare Digestive Care Center at Orange Coast Medical Center frequently perform an endoscopy to examine the digestive tract. The procedure involves gently guiding a flexible tube with a small camera on its end down the throat and into the esophagus, or the tube connecting the throat with the stomach.

For Sandy, the Bravo capsule study provided further insights. A small capsule, about the size of a gel cap, was temporarily attached to the wall of her esophagus during an endoscopy. Over a 24- to 48-hour period, the device measured how often her stomach contents refluxed into the lower esophagus and how much acid the reflux contained.

After a diagnosis of GERD and the hiatal hernia causing it, Dr. Farhadi referred Sandy to general and bariatric surgeon Atif Iqbal, M.D., for surgical intervention. Dr. Iqbal serves as the medical director for the MemorialCare Digestive Care Center at Orange Coast Medical Center and specializes in advanced treatments to cure GERD and other stomach maladies.

“While most of us will occasionally have acid reflux or heartburn, chronic reflux like Sandy’s damages the esophagus,” says Dr. Iqbal. “Long-term, it can lead to a precancerous condition called Barrett’s Esophagus. This was the case with Sandy. Fortunately, we discovered her condition while it could still be treated effectively.”


One in five Americans has chronic acid reflux, or GERD. Anyone can develop GERD, but the likelihood increases as you age. People who struggle with hiatal hernias, obesity, frequent cough, asthma or who are pregnant are also at risk for developing GERD and its complications.

GERD occurs when acid and digestive juices flow out of the stomach and back into the esophagus due to a weak lower esophageal sphincter (LES) muscle.

“Over the counter, acid-blocking antacid medications may provide temporary relief. However, they can also mask symptoms of a disease that is progressing,” says Dr. Iqbal. “In the last 10 years, we’ve seen a 600 percent increase in the incidence of esophageal cancer.”


Dr. Iqbal performed a minimally invasive, robotic-assisted surgery called fundoplication, which is considered the gold standard for treating severe reflux disease. With a 95 percent success rate, fundoplication strengthens the LES, stopping the acid from backing into the esophagus.

“I had just a few tiny incisions. I was home the next day and back to work a week and a half later. I was amazed at how simple it was,” says Sandy.

Dr. Iqbal adds, “Fundoplication robotic-assisted surgery allows for less pain, smaller scars and faster recovery times. The robotic system’s magnified, 3D view yields a high degree of precision in navigating delicate structures that is especially helpful in complex cases.”

Dr. Iqbal is also among the first in the region with expertise in LINX, the latest medical device to correct moderate or severe GERD. He places a small, flexible titanium bracelet with a core of magnetic beads just above the stomach, around the malfunctioning LES, to help keep it closed.

“With LINX, the patient’s reflux is gone immediately,” says Dr. Iqbal. “Orange Coast Medical Center staff are among the first in Southern California to undergo the in-depth training needed to offer LINX.”


Sandy has resumed traveling for business – and pleasure. She often dines on her favorite spicy foods from Mexican, Brazilian and Middle Eastern restaurants. “I’m enjoying food again! I can’t believe I waited so long to find relief,” says Sandy.

If you have acid reflux symptoms two or more times a week, the specialists at the MemorialCare Digestive Care Center at Orange Coast Medical Center are here to help.

Graphic image representing digestive care and link to video


Graphic podcast image and link

Listen to Dr. Iqbal’s podcast to learn about emerging technology and treatments for GERD or watch this short video about the LINX procedure.